T细胞和NKT细胞淋巴瘤的Kim_认知因素及治疗策略.pptx

Prognosticfactorsand

treatmentstrategiesofTand

NK/T-celllymphoma

WonSeogKim

Samsungmedicalcenter

Seoul,Korea

InternationalT-celllymphomaprojectJCO2008

PTCLs

Whatwastheevolutionintreatmentforlastdecade?PTCLsotherthanNK/T-celllymphoma

.CHOP:toostandard

–CHOP+X

.Alemtuzumab/brotezomib/romidepsin/everloimus

/lenalidomide/etc---

–Currenttrials

.Romidepsin+CHOPvsCHOP

.Brentuximab+COPvsCHOPforCD30+PTCLs

.CHOPvsothers?

–CHOPvsICE

–CHOPvsGem-P

*Stratifiedby:

•Nodalvsextranodaldisease

•IPIscore(0/1/2vs3/4/5)

•Region(NorthAmerica+EUvsRestofWorld)

†Crossovertoalisertibaftercomparatorarmwasnotpermitted.

BID,twicedaily;CR,completeresponse;DOR,durationofresponse;ECOGPS,EasternCooperativeOncologyGroupperformancestatus;ECT,enteric-coatedtablet;IPI,InternationalPrognosticIndex;IRC,independentreviewcommittee;IV,intravenous;IWG,InternationalWorkingGroup;OS,overallsurvival;PFS,progression-freesurvival;

ArmB:Single-agentcomparator(investigatorchoice)†

LUMIEREStudydesign

ArmA:Alisertib

Treatment

untildisease

progression

orunacceptable

toxicity

(Patients

achieving≥SD

couldcontinue

treatmentfor

upto2years)

Gemcitabine(currentlynotapprovedforuseinhematologicmalignancy)

•1000mg/m2viaIVover30minutes

•Days1,8,and15;28-daycycles

Romidepsin

•14mg/m2viaIVinfusionover4hrs

•Days1,8,and15;28-daycycles

Pralatrexate

•30mg/m2viaIVpush(3–5minutes)

•Onceweeklyfor6wks;7-wkcycles

•VitaminB12+folicacidsupplements

•50mgBIDECT

•Days1–7;21-daycycles

Secondary:

•OS(key)

•CRrate•DOR

•Safety

Primary:

•ORR(CR+PR)

•PFS(IRC)

OwenOetalASH2015

PR,partialresponse;SD,stabledisease;WHO,WorldHealthOrganisation

Randomization1:1*

Comparator

Response,n(%)

Alisertib(n=96)

All(n=85)

Pralatrexate(n=45)

Gemcitabine(n=22)

Romidep